The etiologies of CTH are multiple (Table 1), and can be pathophysiologically approached and investigated following the oxygen route (Fig. CTH is common and prevalent in neurocritical ill patients, and in most cases, it is due to changes in basic physiological parameters. DO 2 is the result of CBF x CaO 2, which does not allow the detection of local tissue or microcirculatory abnormalities that limit the local supply of O 2 at the tissue level (Fig. When DO 2 is inadequate or the mitochondria cannot use the supplied O 2, ‘‘cerebral tissue hypoxia’’ (CTH) occurs, which constitutes a secondary insult that magnifies the primary brain injury and worsens clinical outcomes, especially in severe traumatic brain injured patients. This requires a good functioning of the respiratory, cardiovascular (including microcirculation) and hematological systems, all regulated by the state of the internal steady. The achievement of oxygen final metabolism, in the mitochondria, starts from ambient air or a gaseous mixture provided by non-invasive O 2 supplemental techniques or mechanical ventilator. Under physiological conditions, the brain utilizes only 33% of the O 2 received, being able to increase extraction when DO 2 is compromised in any of its determinants. Two requirements are essential to ensure the availability of O 2 to the brain (DO 2): sufficient cerebral blood flow (CBF) and adequate arterial oxygen content (CaO 2). Since the brain cannot store O 2, it needs its constant supply to maintain its main energy source, which is adenosine triphosphate. Oxygen (O 2) is vital for neuronal survival. For this purpose, we developed the acronym “THE MANTLE,” a bundle of therapeutical interventions, which covers and protects the brain, optimizing the components of the oxygen transport system from ambient air to the mitochondria. The causes of hypoxia are variable and can be analyzed pathophysiologically following “the oxygen route.” The current trend is precision medicine, individualized and therapeutically directed to the pathophysiology of specific brain damage however, this requires the availability of multimodal monitoring. Brain tissue hypoxia occurs when the supply of oxygen is not adequate or when for some reasons it cannot be used at the cellular level. Multiple physiological parameters determine the oxygen delivered to the brain, including blood pressure, hemoglobin level, systemic oxygenation, microcirculation and many factors are involved in the delivery of oxygen to its final recipient, through the respiratory chain. Cerebral tissue oxygenation represents the balance between oxygen supply and consumption, largely reflecting the adequacy of cerebral perfusion. Usted se desmaya, está confundido o con más somnolencia de la usual.To ensure neuronal survival after severe traumatic brain injury, oxygen supply is essential.Usted tiene preguntas o inquietudes acerca de su condición o cuidado.Sus músculos se mueven de forma impredecible.Anote sus preguntas para que se acuerde de hacerlas durante sus visitas. Puede ser que usted necesite regresar para más exámenes para encontrar la causa de su hipoxia. INSTRUCCIONES SOBRE EL ALTA HOSPITALARIA: Acuda a sus consultas de control con su médico según le indicaron: Otras condiciones pueden llegar a causar que la hipoxia ocurra con el tiempo. Algunas condiciones pueden causar que la hipoxia ocurra de repente. La hipoxia es una disminución del nivel de oxígeno en todo su cuerpo o en parte del mismo, como por ejemplo en su cerebro.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |